Exposure to environmental tobacco smoke (ETS) early in life increases the risk of sudden infant death syndrome, asthma, and respiratory infections contributing to more than 5,000 premature deaths among children in the US each year. African American children suffer disproportionately from the consequences of ETS exposure with well documented higher rates of sudden infant death and asthma. While the roots for these disparities are complex (e.g., poverty, poor housing conditions, environmental allergens), exposure to ETS is a prominent and quickly reversible cause of excess morbidity and mortality. We propose to address this deficit by providing culturally-sensitive biomarker feedback to the smoking parent/caregiver on their child's exposure to tobacco toxins. We will use a client centered motivationally enhanced counseling style to deliver the intervention. Further, delivery of this intervention by community health workers (CHWs) will further increase the salience of the proposed biomarker feedback intervention. With these points in mind, we propose a two-arm randomized clinical trail (N=180) to determine the efficacy of culturally sensitive biomarker feedback documenting a child's exposure to tobacco toxins (NNAL, nicotine, cotinine) to reduce home ETS exposure among African American children. Participants (i.e., the smoking parent or caregiver) will be randomized to receive one of two treatments: Tx1: General Home Safety Intervention - Contact Control Group (Lead Biomarker Feedback) Tx2: Home ETS Reduction Intervention - Treatment Group (Tobacco-Specific Biomarker Feedback) We hypothesize that tobacco-specific biomarker feedback will result in decreased home ETS (air nicotine levels) through increased parental smoking cessation and/or adoption of complete home smoking bans. This study will identify an innovative and effective strategy for reducing ETS exposure among African American children. The proposed delivery of culturally sensitive biomarker feedback can serve as a template for future efforts to bring the promise of personalized medicine to underserved populations.